Madrona Venture Fund IV-A Form 3 SMARTSHEET / Venture Fund III L P Madrona ownership change

SEC Form 3

FORM 3

UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940

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1. Name and Address of Reporting Person^*

Madrona Investment Partners III

(Last)

(First)

(Middle)

C/O MADRONA VENTURE GROUP

999 THIRD AVE., 34TH FLOOR

(Street)

SEATTLE

98104

(City)

(State)

(Zip)

2. Date of Event Requiring Statement (Month/Day/Year)
04/26/2018

3. Issuer Name and Ticker or Trading Symbol
SMARTSHEET INC [ SMAR ]

4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)

Director	X	10% Owner
Officer (give title below)		Other (specify below)

5. If Amendment, Date of Original Filed (Month/Day/Year)

6. Individual or Joint/Group Filing (Check Applicable Line)

	Form filed by One Reporting Person
X	Form filed by More than One Reporting Person

Table I - Non-Derivative Securities Beneficially Owned
1. Title of Security (Instr. 4)	2. Amount of Securities Beneficially Owned (Instr. 4)	3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5)	4. Nature of Indirect Beneficial Ownership (Instr. 5)

Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4)	2. Date Exercisable and Expiration Date (Month/Day/Year)		3. Title and Amount of Securities Underlying Derivative Security (Instr. 4)		4. Conversion or Exercise Price of Derivative Security	5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5)	6. Nature of Indirect Beneficial Ownership (Instr. 5)
1. Title of Derivative Security (Instr. 4)	Date Exercisable	Expiration Date	Title	Amount or Number of Shares	4. Conversion or Exercise Price of Derivative Security	5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5)	6. Nature of Indirect Beneficial Ownership (Instr. 5)
Series A-4 Preferred Stock	⁽¹⁾	⁽¹⁾	Class B Common Stock⁽²⁾	8,099,380	⁽¹⁾	I	By Madrona Venture Fund III, L.P.⁽³⁾⁽⁴⁾
Series B Preferred Stock	⁽⁵⁾	⁽⁵⁾	Class B Common Stock⁽²⁾	5,545,225	⁽⁵⁾	I	By Madrona Venture Fund III, L.P.⁽³⁾⁽⁴⁾
Series C Preferred Stock	⁽⁶⁾	⁽⁶⁾	Class B Common Stock⁽²⁾	3,299,995	⁽⁶⁾	I	By Madrona Venture Fund III, L.P.⁽³⁾⁽⁴⁾
Series D Preferred Stock	⁽⁷⁾	⁽⁷⁾	Class B Common Stock⁽²⁾	1,928,855	⁽⁷⁾	I	By Madrona Venture Fund III, L.P.⁽³⁾⁽⁴⁾
Series E Preferred Stock	⁽⁸⁾	⁽⁸⁾	Class B Common Stock⁽²⁾	785,225	⁽⁸⁾	I	By Madrona Venture Fund III, L.P.⁽³⁾⁽⁴⁾
Series A-4 Preferred Stock	⁽¹⁾	⁽¹⁾	Class B Common Stock⁽²⁾	323,560	⁽¹⁾	I	By Madrona Venture Fund III-A, L.P.⁽³⁾⁽⁴⁾
Series B Preferred Stock	⁽⁵⁾	⁽⁵⁾	Class B Common Stock⁽²⁾	221,520	⁽⁵⁾	I	By Madrona Venture Fund III-A, L.P.⁽³⁾⁽⁴⁾
Series C Preferred Stock	⁽⁶⁾	⁽⁶⁾	Class B Common Stock⁽²⁾	131,830	⁽⁶⁾	I	By Madrona Venture Fund III-A, L.P.⁽³⁾⁽⁴⁾
Series D Preferred Stock	⁽⁷⁾	⁽⁷⁾	Class B Common Stock⁽²⁾	77,055	⁽⁷⁾	I	By Madrona Venture Fund III-A, L.P.⁽³⁾⁽⁴⁾
Series E Preferred Stock	⁽⁸⁾	⁽⁸⁾	Class B Common Stock⁽²⁾	31,368	⁽⁸⁾	I	By Madrona Venture Fund III-A, L.P.⁽³⁾⁽⁴⁾
Class B Common Stock⁽²⁾	⁽²⁾	⁽²⁾	Class A Common Stock	77,637	⁽²⁾	I	By Madrona Venture Fund IV, L.P.⁽⁹⁾⁽¹⁰⁾
Series D Preferred Stock	⁽⁷⁾	⁽⁷⁾	Class B Common Stock⁽²⁾	1,956,060	⁽⁷⁾	I	By Madrona Venture Fund IV, L.P.⁽⁹⁾⁽¹⁰⁾
Series E Preferred Stock	⁽⁸⁾	⁽⁸⁾	Class B Common Stock⁽²⁾	1,433,338	⁽⁸⁾	I	By Madrona Venture Fund IV, L.P.⁽⁹⁾⁽¹⁰⁾
Series F Preferred Stock	⁽¹¹⁾	⁽¹¹⁾	Class B Common Stock⁽²⁾	763,347	⁽¹¹⁾	I	By Madrona Venture Fund IV, L.P.⁽⁹⁾⁽¹⁰⁾
Class B Common Stock⁽²⁾	⁽²⁾	⁽²⁾	Class A Common Stock	1,979	⁽²⁾	I	By Madrona Venture Fund IV-A, L.P.⁽⁹⁾⁽¹⁰⁾
Series D Preferred Stock	⁽⁷⁾	⁽⁷⁾	Class B Common Stock⁽²⁾	49,850	⁽⁷⁾	I	By Madrona Venture Fund IV-A, L.P.⁽⁹⁾⁽¹⁰⁾
Series E Preferred Stock	⁽⁸⁾	⁽⁸⁾	Class B Common Stock⁽²⁾	36,530	⁽⁸⁾	I	By Madrona Venture Fund IV-A, L.P.⁽⁹⁾⁽¹⁰⁾
Series F Preferred Stock	⁽¹¹⁾	⁽¹¹⁾	Class B Common Stock⁽²⁾	19,455	⁽¹¹⁾	I	By Madrona Venture Fund IV-A, L.P.⁽⁹⁾⁽¹⁰⁾

1. Name and Address of Reporting Person^*

Madrona Investment Partners III

(Last)

(First)

(Middle)

C/O MADRONA VENTURE GROUP

999 THIRD AVE., 34TH FLOOR

(Street)

SEATTLE

98104

(City)

(State)

(Zip)

1. Name and Address of Reporting Person^*

Madrona Venture Fund III L P

(Last)

(First)

(Middle)

C/O MADRONA VENTURE GROUP

999 THIRD AVE., 34TH FLOOR

(Street)

SEATTLE

98104

(City)

(State)

(Zip)

1. Name and Address of Reporting Person^*

Madrona Venture Fund III-A LP

(Last)

(First)

(Middle)

C/O MADRONA VENTURE GROUP

999 THIRD AVE., 34TH FLOOR

(Street)

SEATTLE

98104

(City)

(State)

(Zip)

1. Name and Address of Reporting Person^*

Madrona Venture Fund IV, LP

(Last)

(First)

(Middle)

C/O MADRONA VENTURE GROUP

999 THIRD AVE., 34TH FLOOR

(Street)

SEATTLE

98104

(City)

(State)

(Zip)

1. Name and Address of Reporting Person^*

Madrona Venture Fund IV-A, LP

(Last)

(First)

(Middle)

C/O MADRONA VENTURE GROUP

999 THIRD AVE., 34TH FLOOR

(Street)

SEATTLE

98104

(City)

(State)

(Zip)

Explanation of Responses:

1. Each share of the issuer's Series A-4 Preferred Stock will automatically convert into 1.06949 shares of the issuer's Class B Common Stock immediately upon the closing of the issuer's initial public offering ("IPO") and has no expiration date.

2. Each share of the issuer's Class B Common Stock will convert into 1 share of the issuer's Class A Common Stock (a) at the option of the holder or (b) automatically upon (i) any transfer which occurs after the closing of the issuer's IPO, except for certain permitted transfers, and (ii) the date that is the earliest of (x) the date specified by a vote of the holders of not less than a majority of the outstanding shares of Class B Common Stock, (y) seven years from the effective date of the IPO and (z) the date that the total number of shares of outstanding Class B Common Stock ceases to represent at least 15% of all outstanding shares of the issuer's common stock, and has no expiration date.

3. These securities are held of record by Madrona Venture Fund III, L.P. ("Madrona Fund III") and Madrona Venture Fund III-A, L.P. ("Madrona Fund III-A"), as applicable. Madrona Investment Partners III, L.P. ("Madrona Partners III") is the general partner of each of Madrona Fund III and Madrona Fund III-A, and Madrona III General Partner, LLC ("Madrona III LLC") is the general partner of Madrona Partners III. (continued on footnote 4)

4. (Continued from footnote 3): Matthew McIlwain, a member of the issuer's board of directors, together with Tom Alberg, Paul Goodrich, Scott Jacobson, Len Jordon, and Tim Porter, are the managing members of Madrona III LLC, and each may be deemed to share voting and investment power over the securities held by Madrona Fund III and Madrona III-A. Each of such individuals disclaims beneficial ownership over such securities except to the extent of his pecuniary interest therein, and the inclusion of these securities in this report shall not be deemed an admission of beneficial ownership of the reported securities for purposes of Section 16 or for any other purposes.

5. Each share of the issuer's Series B Preferred Stock will automatically convert into 1 share of the issuer's Class B Common Stock immediately upon the closing of the issuer's IPO and has no expiration date.

6. Each share of the issuer's Series C Preferred Stock will automatically convert into 1 share of the issuer's Class B Common Stock immediately upon the closing of the issuer's IPO and has no expiration date.

7. Each share of the issuer's Series D Preferred Stock will automatically convert into 1 share of the issuer's Class B Common Stock immediately upon the closing of the issuer's IPO and has no expiration date.

8. Each share of the issuer's Series E Preferred Stock will automatically convert into 1 share of the issuer's Class B Common Stock immediately upon the closing of the issuer's IPO and has no expiration date.

9. These securities are held of record by Madrona Venture Fund IV, L.P. ("Madrona Fund IV") and Madrona Venture Fund IV-A, L.P. ("Madrona Fund IV-A"), as applicable. Madrona Investment Partners IV, L.P. ("Madrona Partners IV") is the general partner of each of Madrona Fund IV and Madrona Fund IV-A, and Madrona IV General Partner, LLC ("Madrona IV LLC") is the general partner of Madrona Partners IV. (continued on footnote 10)

10. (Continued from footnote 9): Matthew McIlwain, a member of the issuer's board of directors, together with Tom Alberg, Paul Goodrich, Scott Jacobson, Len Jordon, and Tim Porter, are the managing members of Madrona IV LLC, and each may be deemed to share voting and investment power over the securities held by Madrona Fund IV and Madrona IV-A. Each of such individuals disclaims beneficial ownership over such securities except to the extent of his pecuniary interest therein, and the inclusion of these securities in this report shall not be deemed an admission of beneficial ownership of the reported securities for purposes of Section 16 or for any other purposes.

11. Each share of the issuer's Series F Preferred Stock will automatically convert into 1 share of the issuer's Class B Common Stock immediately upon the closing of the issuer's IPO and has no expiration date.

Remarks:

	/s/ Troy Cichos Authorized Signatory on behalf of the Reporting Persons	04/26/2018
	** Signature of Reporting Person	Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 5 (b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
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Madrona Venture Fund IV-A Form 3SMARTSHEET / Venture Fund III L P Madrona ownership change